What I Did With My Biological Sciences Degree by Thaddus Wilkerson


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  • Overseen by the Surgeon General, the U.S. Public Health Service Commissioned Corps is a diverse team of more than 6,500 highly qualified, public health professionals. Driven by a passion to serve the underserved, these men and women fill essential public health leadership and clinical service roles with the Nation’s Federal Government agencies.1798—John Adams, second president of the United States, signed into law the Act for the Relief of Sick and Disabled Seamen. A year later, Congress extended the Act to cover every officer and sailor in the U.S. Navy. The Act led to the gradual creation of a loose network of locally controlled marine hospitals along coastal and inland waterways.1870—Hospital administration was centralized in the Marine Hospital Service, with its headquarters in Washington, DC, under the position of supervising surgeon (later Surgeon General).1871—John Maynard Woodworth, the first supervising surgeon, adopted a military model for his medical staff as part of system reform. Woodworth instituted examinations for applicants, put physicians in uniforms, and created a cadre of mobile, career-service physicians who can be assigned to various marine hospitals.1878—The prevalence of major epidemic diseases such as smallpox, yellow fever, and cholera spurred Congress to enact the National Quarantine Act to prevent the introduction of contagious and infectious diseases into the United States. Congress later extended the Act to prevent the spread of disease among the states. The task of controlling epidemic diseases through quarantine and disinfection measures, as well as immunization programs, fell to the Marine Hospital Service.1889—Legislation formalized the Commissioned Corps as the uniformed services component of the Marine Hospital Service. Congress organized Corps officers along military lines, with titles and pay corresponding to Army and Navy grades.1902—Name of the Marine Hospital Service expanded to Public Health and Marine Hospital Service to reflect growing responsibilities. The Service now carried out the medical inspection of arriving immigrants, such as those landing at Ellis Island in New York, as well as former State quarantine responsibilities. Commissioned Corps officers played a major role in fulfilling the Service's commitment to preventing disease from entering the country.1912—Name of the Public Health and Marine Hospital Service shortened to the Public Health Service (PHS). Legislation enacted by Congress broadened the powers of the PHS by authorizing investigations into human diseases (such as tuberculosis, hookworm, malaria, and leprosy), sanitation, water supplies, and sewage disposal.1930 and 1944—Corps officers expanded to include engineers, dentists, research scientists, nurses, and other health care specialists, as well as physicians.Today—The Commissioned Corps continues to fulfill its mission to protect and promote the public health of our Nation. With more than 6,500 active-duty officers, the Corps is working to create a global world free of preventable disease, sickness, and sufferingThe PHS uniform traces its roots back to 1871 when John Maynard Woodworth, the first supervising surgeon (now known as the Surgeon General), organized the service along military lines. The uniforms reflect the proud legacy and tradition of the more than 200-year-old service. Uniforms link today’s officers to their heritage and connect them to past officers. Since they represent the Commissioned Corps history and tradition, rigorous standards apply to wearing the uniform and every officer upholds those standards with pride.Dental, dietary, engineer, environmental health, medical, nurse, pharmacist, scientist, therapist, veterinarian
  • C3HeB/FeJ mice are highly susceptible to TBVerapamil appeared to enhance the effectiveness of standard anti-TB therapyWith further study, the use of efflux-pump inhibitors may allow for shorter courses of antimicrobialsHowever, drug-drug interactions with verapamil and rifampin in humans is concerning and may not be of utility in humans
  • What I Did With My Biological Sciences Degree by Thaddus Wilkerson

    1. 1. Working as an Infectious Diseases Clinical Pharmacy Specialist Minimizing the Impact through Antimicrobial Stewardship Antibiotic Resistance is a Public Health Crisis
    2. 2.        At this time, I vow to devote my professional life to the service of all humankind through the profession of pharmacy. I will consider the welfare of humanity and relief of human suffering my primary concerns. I will apply my knowledge, experience, and skills to the best of my ability to assure optimal drug therapy outcomes for the patients I serve. I will keep abreast of developments and maintain professional competency in my profession of pharmacy. I will maintain the highest principles of moral, ethical, and legal conduct. I will embrace and advocate change in the profession of pharmacy that improves patient care. I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.
    3. 3.  Mission: Protect, promote and advance the health and safety of our nation. ◦ ◦ ◦  Corps officers are involved in ◦ ◦ ◦ ◦ ◦   disease control and prevention biomedical research regulation of food and drugs mental health and drug abuse health care delivery The origins of the Public Health Service are to be found with sailors and medical care. July 16, 1798 – 5th Congress passed an Act, signed by President John Adams ◦  Rapid and effective response to public health needs Leadership and excellence in public health practices Advancement of public health science “to provide for the accommodation of sick and disabled seamen.” Today: more than 6,500 active-duty officers working to create a global world free of preventable disease, sickness, and suffering. ◦ ◦ ◦ ◦ ◦ ◦ ◦ CDC NIH IHS NOAA FDA CMS BOP
    4. 4. IBM Austin Texas Sport’s Authority Biology & Chemistry Tutor Dispute resolution & mediation Immunology Lab Technician            General Biology Botany Cell Biology Invertebrates Parasitology Virology Microbiology Immunology Anatomy & Physiology Pathophysiology Genetics
    5. 5.  American Association of Colleges of Pharmacy (AACP.org) ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Calculus, Statistics, Physics with lab General biology with lab Human anatomy & physiology Microbiology with lab Upper division bioliogy (ex Molecular) General Chem with lab, organic chem with lab Biochemistry Reading & writing for college or equivalen Public speaking Liberal arts / Humanities Economics Human Behavior (social,behavioral, psych)
    6. 6.         Sante Fe – Policy & advocacy DC – AAIP VA – ambulatory care ID Homeless Shelter Clinics & volunteering with health fairs Reservation PIMC    Walgreen’s IHS Cardiovascular risk reduction
    7. 7.            Retail Outpatient Consultant MTM Inpatient Midlevel Pharmaceutical Industry Research Radiopharmacy Toxicology Academia   Clinical Pharmacy ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ HIV ID Diabetes Cardiovascular Oncology Pediatrics Psych Home Health Critical Care Emergency Travel Medicine
    8. 8.     Broad-spectrum Once daily Oral and IV Works by inhibiting topoisomerase II, IV ◦ Enzyme needed to separate replicating DNA ◦ Blocks cell division  Resistance ◦ Efflux pumps ◦ Plasmid-mediated resistance genes for proteins that block binding ◦ Mutations in DNA gyrase
    9. 9.        More than 2 million people are infected by drug-resistant germs each year 23,000 die of their infections The biggest killer is C. difficile Up to half the antibiotic Rx written are unnecessary. These unneeded antibiotics are making the superbug problem worse. There are not any new antibiotics immediately in development that will kill these. Older antibiotics with toxic side effects are the last line defense. NBC NEWS Sept 16, 2013
    10. 10.         MDR Acinetobacter Drug-resistant Campylobacter Fluconazole-resistant Candida ESBLs VRE MDR Pseudomonas Drug-resistant Nontyphoidal Salmonella Drug-resistant Shigella        CRE MRSA VRSA Drug-resistant Strep pneumoniae Erythromycin-resistant Group A Strep Clindamycin-resistant Group B Strep Drug-resistant TB
    11. 11.     Abx resistant TB Mycobacterial efflux pump promotes intracellular survival and may mediate tolerance to antimicrobials Verapamil – drug for heart disease C3HeB/FeJ mice model of TB – lung lesions like humans ◦ Infected with aerosol M. tuberculosis ◦ Given standard anti-TB treatment (RIPE) + Verapamil ◦ Lung colony-forming units progressively decreased and lower than standard treatment at 2, 4, 8, & 12 weeks ◦ All mice culture negative at 4 months with verapamil ◦ Lower 3-month relapse J Respir Crit Care Med 2013 Sep 1
    12. 12.     Treat infection not colonization Use the most effective drug, dose with the shortest duration Minimize unnecessary broad-spectrum antibiotic exposure Minimize the spread of resistant bugs       Education Guidelines Daily monitoring Restriction Microbiology interpretation Rapid diagnostics
    13. 13. Thaddus D. Wilkerson, Pharm.D., BCPS tdwilkerson@anthc.org (907) 729-2155